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Enablers and barriers of implementing shared governance in nursing departments: a case study from the United Arab Emirates Cover

Enablers and barriers of implementing shared governance in nursing departments: a case study from the United Arab Emirates

Open Access
|Dec 2024

Figures & Tables

Demographic data analysis_

CategoryF%
Gender
  Male426.7
  Female1173.3
Age (years old)
  24–30213.3
  31–451386.7
  46–6000
  >6000
Experience in the hospital (years)
  1–400
  5–151173.3
  15–24426.7
  >2400
Position
  Staff nurse14
  Charge nurse16.7
  Nursing manager00
Unit
  Pediatric Intensive Care Unit (PICU)16.7
  Emergency Department16.7
  Medical ward16.7
  Surgical ward320
  Intensive care unit16.7
  Cardiac care unit16.7
  Operation room320
  Specialized Medical Unit (SMU)10.067
  Outpatient clinics320
Education
  Diploma00
  Bachelor1493.3
  Master16.7
  PhD00

Thematic data analysis_

Questions and sub-categoryFParticipantsMain themes and sub-themes
Could you please tell me what comes to mind when you come across the term shared governance? Participants understand the concept of shared governance.
  Authority and empowerment86[P3, P4, P5, P6, P10, P11]The majority of participants mentioned at least one right phrase or sentence related to the concept of shared governance.
  Sharing/involvement in decision making128[P2, P3, P5, P9, P10, P12, P13, P14]
  Partnership with the management64[P1, P9, P10, P11]
  Teamwork54[P5, P8, P12, P13]
  Sharing the rules or activities22[P1, P7]
  Participation22[P12, P14]
  Accountability11[P9]
  Equity11[P9]
  Improving leadership qualities among nurses11[P8]
In your opinion, what are the expected benefits of implementing shared governance in your hospital? Participants understand the benefits of shared governance.
  Nurses can solve their problems by themselves75[P1, P3, P5, P14, P15]The majority of participants mentioned at least one benefit of shared governance.
  Nurses can escalate their concerns55[P1, P2, P6, P8, P9]
  Nurses will be treated equally22[P3, P11]
  Patients will get a safe and better quality of care.22[P11, P13]
  Nurses become happy.111[P1]
  Improve staff-patient ratio.111[P12]
  The work environment is improved.111[P12]
  Nurses will work as a team.111[P8]
How do you perceive the outcome of implementing a shared governance model in your hospital? The participants demonstrated contradictory views about the outcome of implementing shared governance in their hospital.
  Nurses who have not seen any changes, are aware of any outcome or perceive low outcome.269[P1, P2, P3, P4, P8, P11, P12, P13, P14]A greater number of participants did not perceive positive outcomes of implementing shared governance.
  Nurses who think that they cannot come up with a solution until it is a multidisciplinary approach.11[P1]
  Nurses who think that the work structure itself has empowered all the nurses whether having a shared governance or not.11[P1]
  There are no minutes of meetings or updates shared with the staff like any questions raised or any problem solved.11[P12]
  Not all nurses are raising concerns as they are not asked to do so.11[P13]
  All nurses are under one umbrella.11[P2]A smaller number of participants perceived positive outcomes of implementing shared governance.
  Nurses are happy as they have a group led by nurses to make the decision.11[P5]
  Staff are not afraid to object and they can say and raise their concerns.44[P6, P7, P9, P10]
  Nurses are advocating for their patients and they are not afraid to escalate things.21[P6]
  We have now more unity.11[P7]
  Nurses can start a new project with the shared governance team.11[P7]
  The shared governance council helped nurses to reduce overtime.11[P14]
  Many have improved their leadership skills since individual responsibilities were given to each staff.11[P2]
In your opinion, what are the enablers to implementing shared governance in your unit/hospital? Immediate manager understanding and support could be significant enablers of implementing shared governance.
  Work culture enhances shared governance activities and participation11[P1]Participants perceived several enablers of implementing shared governance, that is, the immediate manager understanding and support, senior management support, work culture, nurse cooperation and teamwork, and multicultural nurses.
  I mmediate manager understanding and support1711[P2, P3, P4, P6, P7, P8, P9, P10, P11, P13, P14]
  Senior management support22[P7, P9]
  Multicultural nurses help a lot11[P14]
  Nurses’ readiness, cooperation, and teamwork are the enablers.33[P5, P8, P14]
In your opinion, what are the barriers to implementing shared governance in your unit/hospital? Participants perceived several significant barriers, mainly nurse’s attitudes and behaviors, lack of management support, and time.
  Some nurses might feel that maybe our concern is not so important.11[P1]Nearly half of the participants (50%) perceived nurse’s attitudes and behaviors as a barrier.
  Nurses will not tell their concerns because they think that they will not be heard or frightened by top management.33[P1, P2, P3]
  Lack of nurse’s interest and commitment.22[P4, P7]
  Some nurses are reluctant to follow suggestions from others.11[P5]
  Some issues cannot be sorted out and it is really hard to find a solution.11[P10]
  Lack of open communication between nurses and the management.11[P2]A greater number of participants (80%) perceived the lack of the senior manager’s support as a barrier.
  Nurses spend their time and come on their off days.108[P4, P5, P8, P10, P11, P13, P14, 15]
  The immediate manager’s authority is limited and not empowered to act or does not act.22[P12, P15]
  The manager does not solve the problem within a given time and they keep promising.11[P14]
  Hierarchy, lack of senior management support, and the management take the final decision.137[P3, P4, P6, P12, P13, P14, P15]
  We don’t get feedback about the problem that was raised.11[P14]
  Nurses mentioned the time as a constraint for implementing shared governance, including conducting convenience meetings and other activities.169[P6, P7, P8, P9, P10, P11, P13, P14, P15]A greater number of participants (60%) perceived the time of meetings and other activities as barriers.
  Nurses turnover43[P4, P5, P15]A small number of participants perceived other barriers, that is, nurse turnover and virtual meetings.
  The meetings turned to virtual due to the COVID-19 pandemic and after.11[P7]
Could you please share any suggestions or recommendations for improving the current shared governance practices in your unit/department? Participants were positive and enthusiastic to improve the current situation of shared governance.
  Involve nurses more/more meetings/involve more nurses.128[P2, P3, P4, P7, P8, P12, P13, P15]A greater number of participants (80%) recommended increasing senior nursing management support.
  Management support/empowering nurses/listening to nurse’s concerns.97[P3, P4, P8, P12, P13, P14, P15]
  To allocate a certain amount of time suitable for nurses to discuss things and do other activities104[P2, P3, P5, P10]
  Adequate staffing11[P5]
  Motivate nurses.42[P9, P15]
  Share the positive outcomes/success stories of the shared governance with nurses to improve their participation.85[P1, P4, P7, P13, P15]A small number of participants (33%) suggested sharing positive outcomes with nurses.
  The nurses should participate/voice out what they want to say/be more proactive.33[P3, P4, P13]A small number of participants suggested that nurses should positively contribute.
  Increase nurse’s awareness of what is shared governance.43[P5, P13, P15]A small number of participants (20%) suggested increasing nurse’s awareness.
  To see some implementation should happen.11[P11]Other participants suggested various strategies to motivate nurses to participate in implementing shared governance.
  Follow-up issues by collecting data, and taking them to the next level are very important.11[P10]
  To set meeting dates as per staff convenience11[P9]
  Assign a special process of writing any issue on a piece of paper and submit it to the shared governance team.11[P1]
  Update nurses by sharing minutes.11[P12]
  Face-to-face meetings are better than virtual meetings.11[P7]
  Involve other allied health professionals.11[P10]
DOI: https://doi.org/10.2478/fon-2024-0046 | Journal eISSN: 2544-8994 | Journal ISSN: 2097-5368
Language: English
Page range: 415 - 426
Submitted on: Jan 12, 2024
Accepted on: Mar 25, 2024
Published on: Dec 16, 2024
Published by: Shanxi Medical Periodical Press
In partnership with: Paradigm Publishing Services
Publication frequency: 4 times per year

© 2024 Siboj Kurup, Anne Paula Manalastas, Jayzafer Ciruelas, published by Shanxi Medical Periodical Press
This work is licensed under the Creative Commons Attribution 4.0 License.